Find all real values of $x$ that satisfy $x + \frac{45}{x-4} = -10.$

Enter all the solutions, separated by commas.
Answer: Multiplying both sides by $x-4,$ we get $x(x-4) + 45 = -10(x-4),$ or $x^2-4x+45 = -10x+40,$ which simplifies to $x^2+6x + 5 = 0.$ This quadratic factors as $(x+1)(x+5) = 0,$ so either $x=-1$ or $x=-5,$ both of which we can check are valid solutions. Therefore, the answer is \[x = \boxed{-1, \; -5}.\]